HYPERMOBILITY HACKS

Physical Therapist Explains: The Real Reason People Who Are Hypermobile Wake Up With Migraines

Millions are being treated for migraines they don't actually have.

A new study exposes a blind spot in how hypermobility is treated: Doctors keep treating migraines like it's a brain problem. But for many sufferers, the real culprit is their neck.

July 9, 2026 at 2:49 pm EDT

My name is Dr. Derek Coleman, a physical therapist who specializes in hypermobility. Recently I had the honor to study 2,365 patients who wake up with migraines.

 

Nearly every one of them had been told the problem was simply "in their head."

 

But when I asked more questions, many described persistent pain and tightness in their neck and at the base of their skull.

 

Most had already tried medications that provided little to no improvement.

 

That's when I noticed something many doctors weren't evaluating closely.

 

In patient after patient, the real problem wasn't coming from the brain at all.

 

It was coming from instability and excessive muscle tension in the upper neck particularly around the C1 and C2 vertebrae, where the head and neck meet.

Your Neck Is Causing Your "Migraines"

Most people with hypermobility don't realize how connected their neck is to the pain in their head.

 

The muscles at the base of your skull specifically around the C1 and C2 vertebrae control blood flow to your brain and house the nerves that send pain signals throughout your head.

 

In a hypermobile body, the ligaments supporting the cervical spine are often loose which means the neck joints themselves can become unstable. During the day, your muscles work to hold everything in place. But at night, lying down for hours, that support disappears. Without something holding your neck in proper alignment, the unstable joints shift, and the surrounding muscles overwork trying to compensate. And when they do, three things happen:

 

First, this muscle strain compresses the vertebral arteries, the main blood vessels supplying oxygen to your brain. Reduced blood flow can trigger throbbing pain, pressure behind the eyes, and that "heavy head" feeling so many hypermobile people describe.

 

Second, that same joint instability irritates the occipital nerves that run through the area creating sharp, radiating pain that travels from the base of your skull up and over your head, until you wake up in pain that feels exactly like a migraine.

 

Third, the irritated nerves send pain signals to your brain's pain centers, and your brain reads it as a migraine attack.

 

Here's the part most people miss:

 

When headaches are triggered by your neck, not your brain, they're called cervicogenic headaches and they feel identical to migraines.

 

That's exactly why so many hypermobile people are treated for migraines when the real problem is happening in their neck.

 

Why Neurologists Get It Wrong

Kendra Gagnon spent 10 years trying everything she was recommended by specialists before she found out what was actually wrong.

 

"I tried every preventive strategy for migraine in the universe, topamax, neurontin, beta blockers, valproate, Botox, vitamins, herbal remedies, psychotherapy." she says.

 

"Nothing touched the frequency. All of it was useless."

 

"I kept telling them my neck felt tight and heavy before every headache. They'd nod and write another prescription. Not one doctor actually examined my neck."

 

Kendra's story isn't unusual: it's what happens when neck instability gets missed.

I explained why:

 

"When someone presents with severe headaches and throbbing pain, neurologists automatically think of migraine. We're trained to look at brain chemistry, not neck mechanics."

 

MRI scans show the brain is fine. Blood work is normal. So the pattern continues another medication, another medication class, while the actual cause goes unaddressed.

 

Meanwhile, the real problem is the unstable joints forcing the surrounding muscles to overwork, compressing arteries and irritating nerves at C1-C2 every night you sleep without support, it gets a little worse.

Why Migraine Prevention Can't Fix This

Even when someone suspects their neck is involved, standard treatments often fail to help.

Preventive medications like Topamax, Neurontin, beta blockers, and valproate are designed to change brain chemistry; they don't address instability in the cervical spine.

 

Botox targets surface muscle activity, not the deep structural compression happening at C1-C2.

 

Pain pills can mask the symptom temporarily, but they don't do anything to stabilize the joint causing it.

 

Physical therapy can help some people, but it's addressing muscle tension without addressing why the muscles are overworking in the first place, the underlying joint instability.

 

Vitamins, herbal remedies, and psychotherapy may support overall wellbeing, but none of them target the structural cause.

 

This is why I started researching alternative solutions.

The Overnight Method That Actually Works

I found something remarkable:

 

Sleeping with your pillow in a 15° incline reduces neck pain that lead to cervicogenic headache in three simple ways:

 

Preventing Hyperextension: In a hypermobile neck, loose ligaments make it easier for the head to tilt too far back or to the side while sleeping flat, since there's less natural resistance holding the joints in place. A 15° incline helps keep your head cradled in a neutral position, so the neck isn't left to hyperextend into a position your ligaments can't stabilize on their own.


Reducing Muscle Guarding: When the neck feels unstable, the surrounding muscles tend to tense up and "guard" the joint which is often what leads to that tight, overworked feeling at the base of the skull. By supporting the neck's natural position throughout the night, the incline reduces the amount of instability your muscles have to compensate for, so they don't have to stay contracted for hours at a time.

 

Maintains Proper Spinal Alignment:

Because hypermobile joints are loose, even small shifts in head position can pull the cervical spine out of alignment while you sleep. The 15° contour is designed to keep your neck supported in line with your spine, rather than letting it drift into positions that put uneven pressure on the joints and surrounding nerves.

 

Upon reading forums from many people with hypermobility who’ve tried 15° incline pillows, most loved them but there were still two massive complaints.

Why Puria Is What I Recommend To Hypermobile Neck & Cervicogenic Headache Sufferers

Here’s what standard cervical pillows got wrong for people with hypermobility:

 

Problem 1: They're too rigid. Most cervical pillows are built with a single firm surface. For a hypermobile person, that's a problem. When you shift positions at night side to back, back to stomach a rigid pillow doesn't move with you. Your neck ends up fighting the pillow for a stable position instead of being supported by it. The result: constant repositioning, disrupted sleep, and muscles that never fully stop guarding.

 

Problem 2: The height is fixed. A pillow that's too high pushes your neck into flexion. Too low, and it drops into extension. Either way, a hypermobile neck that can't stabilize itself is being held in the wrong position for hours. Most cervical pillows give you one height and hope it fits.

 

The Puria Cervical Pillow was designed in a 15° incline along with a 6 zone ergonomic mechanism and adjustable loft specifically to solve both :

 

6 zone ergonomic mechanism: Separate contoured zones support your neck, shoulders, and arms differently depending on whether you sleep on your side, back, or stomach. Whatever position you land in, the areas around your neck get shaped support instead of a single rigid surface so your neck stops searching for a stable spot and your muscles can actually release.

 

Adjustable loft: The reversible, removable-insert design lets you dial in the exact height your neck needs to stay level and supported. Not too high, not too low the position where your cervical spine stays aligned and your muscles don't have to compensate.

 

Together, these don't just make you more comfortable.

 

They're designed to give your neck the support it doesn't get on its own while you sleep, which matters more, not less, if your ligaments are already loose and your neck can't stabilize itself.

What I Witnessed in My Patients Was Remarkable

Greg Palmer suffered with debilitating neck pain and headaches for 4 years.

 

“I was waking up with pain in my neck and the base of my skull. By mid-afternoon, it would turn into a full-blown headache 50% of days.”

 

Three neurologists diagnosed her with chronic migraines.

 

"They put me on Topamax, then Aimovig, then tried Botox. I spent thousands and still had headaches 15 days a month."

 

I told Greg about cervicogenic headaches and he realized his symptoms matched perfectly especially the neck tightness that always came before the head pain.

 

"I ordered Puria and used it every night. Within a week, I was starting each day from a 2/10 instead of a 7 out of 10. By week three, I'd gone several days without a headache, my longest streak in 4 years."

 

But the moment I’ll never forget?

 

Kendra Gagnon came back after two weeks of using Puria.

 

She walked into my office and she was smiling.

 

“For the first time in 10 years, I wasn’t crying every single day because of how excruciating the headaches were.”

 

That’s the moment I know I had to share this with the hypermobility community.

 

Puria helped thousands of people with cervicogenic headaches.

 

These aren't rare cases.

 

Over 3,000+ people report similar results.

 

And I’m confident it’s going to help you too.

 

Just imagine waking up and not bracing yourself for neck pain.

 

Getting through your week without daily cervicogenic headaches.

 

All of that becomes possible when you support what was really causing the pain, your neck.

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